RECONSTRUCTION OF NASAL ALA DEFECTS USING THREE STAGED FOLDED FOREHEAD FLAP: AESTHETIC AND FUNCTIONAL OUTCOMES

Abstract

Objective: To assess short and long term aesthetic and functional outcomes of nasal ala reconstruction by three staged folded forehead flap.
 Study Design: Prospective study.
 Place and Duration of Study: Plastic and Reconstructive Surgery Department of Combined Military HospitalBahawalpur and Quetta, from Dec 2014 to Dec 2018.
 Methodology: Total of 29 patients were enrolled through consecutive sampling technique. Nasal ala defects were reconstructed by three staged frontal forehead flap under general anesthesia. Follow up visit at 2 weeks bleeding, wound Infection, partial skin graft loss and partial flap necrosis was documented. Follow up at 24 weeks, functional outcome of nasal reconstruction was assessed by history and clinical examination for nasal obstruction and/or crusting. Patients’ subjective satisfaction about aesthetic outcome of nasal reconstruction was documented on 5 point likert scale. Objective aesthetic assessment of reconstruction was done on 2D photograph by two independent surgeons.
 Results: Twenty six (89.66%) males and 3 (10.34%) females participated in study. The mean age was 35 yearsrange 16 to 64 years. Follow up at two weeks revealed postoperative bleeding in 2 (6.8%), wound infection in 1(3.4%) and partial flap loss in 1 (3.4%) patient. At 24 weeks follow up all patients had patent nasal ala. Subjectiveand objective assessment of nose shape was documented.
 Conclusion: Use of three staged folded forehead flapis useful method of reconstruction for full thickness defects of nasal alaewith good functional and aesthetic outcome.